Percutaneous Left Atrial Appendage (LAA) Occlusion With Gigantic LAA Using a Custom-Manufactured LAmbre Device

Korean Circ J. 2024 May;54(5):291-293. 10.4070/kcj.2024.0014.

Affiliations

¹Department of Cardiology, Ajou University School of Medicine, Suwon, Korea
²Division of Cardiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea

Figure

Figure 1 Measured diameters of landing zone and ostium of LAA and the custom-manufactured occlusion device. (A) Computed tomography of the LAA showing landing zone (green line) and ostium (red line). (B, C) Transesophageal echocardiography images of LAA showing landing zone (green line) and ostium (red line) in views at 45 degrees (B) and 135 degrees (C). (D) Custom-manufactured occlusion device with a 42 mm umbrella and a 44 mm cover, along with a 17.5 mm distance from the cover to the tip and an 11.9 mm distance from the cover to the landing zone.LAA = left atrial appendage.
Figure 2 Percutaneous LAA occlusion using a custom-manufactured device. (A) Fluoroscopic images fused with computed tomography images using HeartNavigator in the process of deployment of the custom-manufactured device. The device was introduced into LAA and (B) fully unsheathed. After confirming the position and peri-device leak by transesophageal echocardiography and fluoroscopy, (C) the device was deployed successfully.LAA = left atrial appendage.
Figure 3 Intraprocedural transesophageal echocardiography measured the diameters of the umbrella of the device in the 45-degree (A) and 135-degree views (B). The maximum diameter was 36 mm.
Figure 4 Transesophageal echocardiography conducted three months post-procedure confirmed the device was correctly positioned (A), and color Doppler echocardiography revealed no peri-device leakage (B).